St. Marks Baths

1
St. Marks Baths
2
Brief History of HIV/AIDS
3
Pre-1981 The Prelude

• June 28, 1969 at 120am, an unexpected police
  raid was carried out on a bar in Greenwich
  Village, New York City. Usually, the patrons
  would submit to whatever humilities the police
  would dole out, but on that particular night,
  enough was enough. The riots lasted five days and
  ultimately launched the gay liberation movement.

4
The Bathhouses

• Remember Bette Midler?
• Originally steam baths
• Became gay sex clubs
• All sexually transmitted diseases went up
  dramatically
• Nearly every patron became infected with HBV
  during the mid and late 1970s

5
1981 GRID

• A very small number of gay men show up with very
  rare diseases in different cities
• Docs tell local health officials, who tell the
  CDC
• CDC sets up a surveillance system and a
  classification system based on symptoms
• Same thing that is being done for SARS

6
Recognizing AIDS

• As cases were identified, new patterns emerged
• New case definition and acronym
• Acquired
• Immuno-
• Deficiency
• Syndrome

7
The Epidemiology

• Classic public health investigation
• Physicians report cases
• Public health investigators collect information
  and other contacts
• Contacts are traced to figure out the network
• Patterns are compared to other diseases
• Same people, same places as HBV
• Blood-borne
• Sex or Needles

8
1982 1983

• We know AIDS is blood-borne
• We do not know what causes it
• We know that it has the same epidemiology as
  hepatitis B, and infects many of the same people
• We know that hepatitis b spreads quickly through
  gay bathhouses
• It is pretty clear that HIV spreads in the same
  way
• Sexual transmission
• IV drug transmission

9
The Emergency Rule

• Why make a rule before ordering the bathhouses to
  close?
• Why do it as an emergency rule?
• Who will want to oppose the rule?
• What is the scientific justification for the
  rule?
• That is the legal authority?

10
The Injunction

• What is the rationale for the injunction?
• What is the counter argument by the bathhouse
  owners and gay activists?
• How do they argue that it easier to control AIDS
  by keeping the bathhouses open?
• Why does the health department reject this
  approach?
• What would be the burden on the health department
  to use this method?

11
The Court's Ruling

• ... defendants and the intervening patrons
  challenge the soundness of the scientific
  judgments upon which the Health Council
  regulation is based .... They go further and
  argue that facilities such as St. Mark's, which
  attempts to educate its patrons with written
  materials, signed pledges, and posted notices as
  to the advisability of safe sexual practices,
  provide a positive force in combating AIDS, and a
  valuable communication link between public health
  authorities and the homosexual community. While
  these arguments and proposals may have varying
  degrees of merit, they overlook a fundamental
  principle of applicable law  "It is not for the
  courts to determine which scientific view is
  correct in ruling upon whether the police power
  has been properly exercised. The judicial
  function is exhausted with the discovery that the
  relation between means and end is not wholly vain
  and fanciful, an illusory pretense.